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About the author

Harold G. Koenig, MD, is board certified in general psychiatry, geriatric psychiatry, and geriatric medicine. He is on the faculty at Duke as professor of psychiatry and behavioral sciences and associate professor of medicine. Dr. Koenig is Director of Duke’s Center for Spirituality, Theology and Health and has published extensively in the fields of mental health, geriatrics, and religion, with over 350 peer-reviewed articles and book chapters and close to 40 books in print or in preparation. He is also a registered nurse.

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"It is inspiring to see a physician who is unafraid to stand up for his religious beliefs and who understands how those beliefs can resonate with good science." —Larry Dossey, MD, author of Reinventing Medicine and Healing Words

The name Harold G. Koenig is well known in the fast-growing field of spirituality and health. Founder and director of the widely respected Duke University Center for Theology, Spirituality, and Health, Dr. Koenig is recognized worldwide for his groundbreaking work in medical science and religious faith. In this book—now available in paperback—he shares his remarkable personal story and shows how personal trials became the catalyst for his pioneering research.

In part one, he describes his turbulent youth: growing up on a California vineyard, college days of experimentation during the 1970s, adventures as a student researcher in Africa with Jane Goodall, an emotional breakdown, expulsion from medical school for disruptive behavior, battling mental illness as a street person in San Francisco. He refers to his ongoing battle with a chronic and debilitating physical disease in terms of the insights it gives him for his work, and he recounts the striking realization of God's call, the people and events that helped him refine a vision into a mission, and the subsequent professional opposition that resided alongside his success.

Part two draws on the real-life examples of former patients and summarizes Koenig's most important findings concerning the impact of Christian faith on mental and physical health, encapsulated by the statement: religious faith and practice are connected to mental and physical health.

In part three he challenges individuals and the American church to consider the implications of the research and to develop constructive ways of implementing the healing connection that can be found in faith.

I either inherited or learned much of my determined nature, a deep-seated spirit of independence, a personal strength that combined physical stamina with emotional resolve, my love for the outdoors, my lifelong quest for knowledge and learning, and even a strong work ethic from the same person. Without a doubt, my mother was the single greatest influence on my life as I grew up. She was always there for me. And because I was an only child growing up on a small family farm in the San Joaquin Valley of California, I was always there with her. My very earliest childhood memory is of waking up in her bedroom on a beautiful spring morning and hearing a robin singing outside an open window. I have a picture of me as a baby, out in the vineyard in a swinging sort of cradle where she’d keep me, so I could play and watch as she and my father went up and down the rows picking, pruning, or doing whatever else they were doing among the grapevines—always hard at work under the relentless summer sun. But perhaps the most revealing picture I can paint of my now eighty-four-year-old mother is a recent anecdotal one. Just a year or so ago, she drove her Toyota van to the nearby town of Lodi to run some errands. There, while loading her groceries and assorted farm supplies, she somehow dropped her keys on the seat and locked them inside the vehicle. So what did she do? She walked seven miles home from Lodi, stopped just long enough to grab the extra set of keys and check on my invalid father, pulled an old bicycle out of the garage, pedaled the seven miles back into Lodi, unlocked the van, hoisted the bike into the back, and drove home. My mother’s own personality was shaped by the hardship and trauma of growing up in Germany during a time that spanned the Depression and both world wars. One of eight children born to hardworking countryfolk, four of her six brothers were killed fighting on the Russian front during World War II. My GI dad met my mother when advancing Allied troops took over and occupied my grandmother’s home. Dad, whose grandparents had emigrated from the Ukraine to Canada before moving to the Dakotas and then on to California during the Depression, could speak some German. Mom soon learned a little English. But they each proved fluent enough in the other’s language that after my father came home in 1946, they corresponded until my mother joined him in 1949. They married right away, and with the meager income my father made pressing clothes at a cleaners in Lodi, they slowly saved enough money to purchase my grandparents’ twenty-acre family farm where they lived when I was born on December 25, 1951. As soon as I was old enough to toddle around the vineyards, my mom found productive work for me to do. My very first paying job was to follow along behind the pickers with a small tin can, gathering grapes they had overlooked or dropped. Mom paid me a nickel for every full can of gleanings I added to the harvest. When I grew older, she paid me for pruning vines and also offered a bounty for eve ry gopher I could trap because the pesky little rodents loved chewing on grapevine roots. I earned additional money when she paid me for the produce I raised in our family’s vegetable garden. I loved working on the farm with my father as well. Sometimes when I’d go with him to the cleaners, I’d earn a little money there, putting those protective cardboard pads on wire hangers dry cleaners used when they returned your clothes. Dad played catch with me, I rode on his back during playtime, and he often took me fishing to the nearby Mokelumne River. He was always a hardworking provider for our family. But my mother was very much in charge of my parenting, household business, and a lot of other family decisions. She was the one who determined she and my father would become a foster family by taking in and caring for a long line of children who lived in our home and served as temporary siblings for me from the time I was born until I was four years old. Mother also took the lead when it came to our family faith. She wanted me raised in the Catholic Church like she had been. So I was baptized as a baby by old Father Morris. I actually recall going to Father Coleman’s confirmation classes with my Dad when he converted to Catholicism. I also have vivid memories of catechism classes for my first communion at age seven and Sunday school every week. Her faith always seemed important to my mother.We prayed before meals and every night before bedtime. Sometimes she’d pray in German, which not only seemed to connect her with God but with her own personal heritage as well. I learned quite a bit of German myself growing up. Not just from listening to my mother’s prayers, but because my folks, instead of resorting to spelling like most parents who don’t want young children to know what they are talking about, often used German when conversing with each other around home. So I had a lot of motivation to become somewhat bilingual, which served me well when it came to another two of the most memorable events of my childhood. At the age of four and again when I was eleven, I accompanied my mom and dad on trips back to Europe to visit her family. What an experience for a small boy to be doted on by my older female cousins, to be given free reign at the restaurant/tavern my grandmother operated, and to roam about in the forest near my grandmother’s home in the town of Aachen near the borders of Germany, Belgium, and Holland! In the years in between those two trips, my grandmother gave me ample opportunities to work on my German when she came on visits to see us in California. That, too, provided real adventure and fun for me because Grandma was quite the outdoorswoman. Growing up in California and living on a farm, I hadn’t spent a lot of time indoors. Nevertheless, all the fun boyhood times I spent with my grandmother, hunting pheasants and rabbits in nearby fields, helped instill in me an even greater love and appreciation for outdoor adventure and experience. Most people of my generation associate November of 1963 with the assassination of John Kennedy. But for me, that fall brought a much more personal tragedy. Just months after my mother and I returned from visiting in Germany the summer I was eleven, we received word my grandmother had been seriously injured in an automobile accident. But she improved steadily over the next couple weeks and seemed to be on the road to recovery. Then, on what was the saddest day of my childhood, my mother re c e i ved another overseas call. After she got off the phone, she told me my grandmother had died suddenly from a blood clot to the lungs that resulted from the injuries sustained in the accident. I remember Mother asking me to pray with her. The two of us knelt on the floor at the bottom of the stairs in our two-story farmhouse and said the rosary together. When we finished, I looked up and was surprised to see tears in my mother’s eyes. That was the only time in my life I have ever seen her cry (except later when my father died in March 2003). In addition to being a strong character model and having an absolutely amazing work ethic, my mother had yet another major influence on me through her commitment to, and her belief in, the importance of education. No doubt one reason she valued learning so highly was because of the lack of opportunity she had growing up where and when she did, as a female in a traditional European farm family. Whatever the impetus or the inspiration, she always viewed my education as the one and only key guaranteed to open the door to a bright and successful future. I learned very early in my scholastic career that my mother viewed education as the highest priority. Studies, whether that meant preparing for a test or just doing homework, were the one thing that always took precedence over my daily farm chores. My first significant academic achievement took place in the second grade. I’d started school as a fairly average student. But that second grade year I’d shifted into a competitive mode, particularly in regard to one of the second grade classmates I had a little crush on. Since to me she seemed by far the smartest student, I thought by doing well myself, I had a better chance of earning her respect—or at least gaining a little of her attention. The result being that at the end of the school year, when our teacher announced the scholarship award to be given to the most outstanding second grade student, I was totally surprised to hear the name “Harold Koenig” called out. I still remember the feeling of pride I experienced walking to the front of the classroom to receive a small pewter plaque. A little ribbon attached said “Scholarship Award.” That was it. My name wasn’t even on it. But when I took that plaque home at the end of the day, my mother was very proud. I went all the way through eighth grade in a little four-room schoolhouse visible over the vineyards from my house. While I earned a measure of respect from my peers on the playground for my athletic ability, I have to say I received even more positive affirmation and a bigger part of my identity from what I achieved in the classroom. Graduating from eighth grade at our little rural school presented me with a choice, though I think my parents had made up their minds years earlier. I could attend the public high school in Lodi with most of the kids I’d gone to school with all my life. Or I could enroll at St. Mary’s, a Catholic high school in Stockton, twenty-five miles away. Mom clearly preferred St. Mary’s, not just because it was a parochial school, but because she was convinced I’d get a better academic background there. Many of the kids I went to church with attended St. Mary’s. So it wasn’t as if I wouldn’t know anyone there. I figured my mother was probably right about the higher academic standards. And by this time, I’d bought into her beliefs on the value of education. So I opted for the Catholic high school experience both my parents wanted for me. In part because I figured any advantage would be helpful in the pursuit of yet another educational goal I had set my sights on. Early in my teen years, one of my mother’s German nieces came to California for a visit with us and with her American boyfriend who had graduated from and now worked at Stanford University just south of San Francisco in Palo Alto. I thought my cousin’s boyfriend was very cool. Perhaps learning that Stanford was sometimes referred to as “the Harvard of the West” also made a real impression on my mom. Whatever the deciding factor, from that time on, she gave her unflagging support for my dream of one day attending Stanford. I realized the entrance requirements at Stanford were rigorous. I also knew the cost of a college education there would certainly not come cheap. The solution to both those hurdles was the same: a record of scholastic excellence in an academically strong and respected secondary school. St. Mary’s met that criterion. I don’t think I realized or appreciated the commitment this required of my parents. Not just financially, but in terms of time and convenience. Instead of catching the public school bus that had stopped at the end of our driveway every school day morning for eight years, one of my parents had to drive me into town every morning to catch a special bus that picked up other Lodi kids who attended St. Mary’s and took us to Stockton. Mom or Dad would then have to meet that bus every afternoon. Or, any day I stayed for sports or other after-school activities, someone would have to make the fifty-mile round trip to bring me home. I felt right at home at St. Mary’s from the start. I played baseball in my sophomore year, but I mostly concentrated on my studies. And I didn’t have much of a social life at all during my first two years. I’d been an altar boy at church during seventh and eighth grades. That was the time soon after Vatican II, when the Catholic Church began holding some masses in English rather than in Latin. Along with a less formal style of worship, there were new and interesting opportunities for lay participation. As a teenager, I was happy to do the lay reading of Scripture or take part in other ways at church. Like many of my peers finally learning to reason for themselves, however, I remember the beginnings of adolescent doubts. Working in our vineyard pruning vines under a cloudless blue sky with the hot sun beating down on my back, I remember thinking serious thoughts and questioning the existence of God. But as the years passed, such questions seemed less relevant, or at least less pressing to a teenager more concerned about who I was and how I fit into this world than who God was and if there even was a next world. The horizons of life expanded my junior year: first because I could finally drive our family Volkswagen, and second when I became best friends with a new student who’d just transferred to St. Mary’s. I probably became closer to Ronald* than I ever have to any other male friend in my life. The fact that we competed intensely in sports and in the classroom only strengthened the bond between us. He beat me out for the physics award and planned to pursue a career in engineering, but I topped him for the biology award and was beginning to think about future possibilities in medicine. Because Ronald was a wrestler, I let him talk me into going out for the school team my junior year. While I had always been quick and athletic, I didn’t have the combination of flexibility and upper-body strength needed to be a good wrestler. So I could never seriously compete with Ronald on the mat. My overall record as a wrestler that year was something like three wins to twenty-seven losses. When I did qualify to compete for our team in an actual meet, my primary goal was just to avoid being pinned. Because if I got pinned, my opponent got five points, and if I simply lost the match, he only got three. If it sounds like I had a defeatist attitude, I really didn’t. I was more than willing to try anything for a competitive edge. When the wrestling coach suggested I might improve my odds if I could just drop enough weight to qualify for a lighter division, that my natural strength would serve me well against smaller opponents, I decided to give his advice a try. I starved myself for almost a month, took laxatives, ran until I dropped, wrestled until I’d get dry heaves, and then took long, hot showers in a makeshift sauna the coach created in the dressing room to sweat off even more pounds. I dropped from the 156-pound class all the way down to the 132-pound division in less than a month. Obviously, that sort of sudden and deliberate weight loss in a healthy adolescent boy with little or no body fat is a medically foolish idea. It turned out not to be a very effective training tactic, either. Dropping that much weight that quickly left me so weak I couldn’t compete with smaller but physically fit opponents who were competing at their natural weight. I went through one of those unpredictable adolescent growth s p u rts between my junior and senior years, suddenly bulking up enough (to 176 pounds) that I played first-string varsity football for the St. Ma ry’s Rams my senior year in high school. That experience gave me a taste of a whole different level of athletic prestige at school. And my moderate gridiron success encouraged me enough to give the wrestling team another try. I’d gained enough size and strength to win a few matches my senior year. I even had fleeting hopes of competing for the Central Valley Conference championship, until the championship match. Sizing up my opponent before the contest, I foolishly decided I could outmuscle him. But I no sooner went for the advantage with my opening move, than he reversed my hold, picked me up off my feet, slammed me to the mat, and had me pinned. While I was walking back to the bench after my loss, everyone was asking, “What happened?” because they’d missed the whole thing. But I didn’t feel much like rehashing it for them. So much for my days of high-school wrestling glory. However, during those last two years at St. Mary’s, Ronald and I were practically inseparable—on and off the playing fields, in and out of classes, before and after school. We hung out a lot of the time with Ronald’s younger brother Richard and another friend named Dave. Like countless boys before and since, we fell victim to that all-too common but potentially lethal mix of teenage stupidity and raging testosterone. The combination inspired a lot of predictable behavior: cruising for action onweekend nights; more than a little indulgence in alcohol; and on one occasion, a macho face-off and fight with a gang of local teenage thugs. And the entirety of that two years worth of shared adolescent behavior somehow mystically bonded the four of us for life, or so we thought. That was about the extent of my experience with girls as well. I didn’t have what anyone would call a very active social life. Oh, there was a handful of dates. But I stayed so busy with studies, sports, and cutting loose with my guy friends that there wasn’t enough time left over for anything remotely resembling a serious relationship with a member of the opposite sex. Besides, the girls I might have been interested in never seemed very interested in me. Indeed, the most memorable and significant interaction I had with a girl during my four years in high school wasn’t at a prom, during a party, or even on a date. It took place before class one day as I was walking down a school hallway with a girl who rode the same school bus I did from Lodi to Stockton eve ry morning. Marty wasn’t a girl I was ever interested in. She was just a good friend. We’d known each other for two years and spent a lot of miles talking about anything and eve rything while we rode the bus. But on this particular occasion, Marty said something in the hallway that made a tremendous difference in my life. “Harold,” she told me, “you’re a really smart guy. And you have a lot going for you. But not very many people know what a neat person you are, because you don’t let people see that side of you. You really should try to be a lot friendlier!” I instinctively felt a little defensive. I had friends. “What do you mean?” I wanted to know. “Well,” she said, “you could start by smiling a little more. And just saying ‘Hi’ and greeting people when you meet them in the hall.” During my next class, I thought about what Marty had said and decided she might be right. Maybe I could be a little friendlier. When the bell rang and I started down the hall to my next class, I began a little social experiment. I made a deliberate effort to look at the people I met, smile, say “Hello,” and even greet those I knew by name. I couldn’t believe the reaction I got. There were a lot of surprised looks, but even more returned smiles. An impressive number of people greeted me by name in reply. I was so amazed by the overwhelmingly positive reaction that I conducted the same experiment again after each of my remaining classes. Then I did it again the next day and the next and the next, until my little exercises in friendliness became a habit and some other people were taking the initiative by smiling and greeting me by name in the hall before I had a chance to do or say anything myself. It felt like I’d found the long-lost secret to high-school popularity. And it all seemed so incredibly simple. Of course it was years later before I realized the bigger secret—that the vast majority of adolescents (and an awful lot of adults) feel so unsure of themselves, so concerned about how others are viewing them, so wrapped up in themselves, and so preoccupied with their own feelings and always looking inward that when they encounter anyone who acts confident enough to notice them, to risk speaking out, and to actually take the initiative in the simplest of social interactions, they are often and unduly impressed. In truth, I realized I was the same shy and introverted person I’d always been. I knew my friendliness was an act. But it wasn’t so much an act of deception as it was an act of will. And by deliberately and consistently acting friendly, I eventually became a much friendlier and popular person—so much so that my final year in high school when I ran for senior class president, something I would never have even considered before, I tied with Alfred Hebert before losing the runoff election. So I will be forever indebted to Marty, because the lesson I learned following her simple advice to become more friendly worked just as effectively in college. And it’s served me well ever since. Without her advice, I might have missed out on my biggest high-school honor and a major steppingstone in the path that eventually led me to where and who I am today. During my final year at St. Mary’s, I received the Seymour Memorial Award given to the person the state awards committee votes the top graduating senior in northern California. The award was based on academic achievement as well as on athletic participation, community involvement, service to others, and positive interaction with peers. That honor, along with my 4.0 grade point average and being the 1970 valedictorian at St. Mary’s High School, won me a full academic scholarship to Stanford University. I think everyone who knew me envisioned this as the first step toward a bright future of seemingly guaranteed happiness and success, but then none of us could have ever anticipated the challenges that lay ahead. less

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ContentsIntroduction 1 The Journey BeginsPart 1: One Man's Story2 Early Days 3 From Books to Buffaloes4 Butterfly Hunter 5 From Med School to Madness6 Empty House, Empty Life7 Healed and Called 8 Publish His Glorious ActsPart 2: The Research Findingsix 1152737475969899 Hoping, Coping, and Growing: The Duke Studies 9710 Getting, Giving, and Living: The Duke Studies Continued11111 The Evidence Piles Up125Part 3: The Link for Us12 Red Flags-When Faith Does Not Heal14513 What Does the Research Mean?16514 How Should We Respond?18515 The Call to Care197